Bioethics Blogs

Guest Post: What puts the ‘mental’ in mental illness?

Written by Anke Snoek

Macquarie University

I have a 3 year old who doesn’t eat. He seems not to be interested in food in general. We were offered many explanations for why he doesn’t eat and most specialists suspect a psychological source for his lack of appetite. But recently a friend suggested that maybe there is something wrong with the muscles in his mouth that makes it hard to swallow. I wondered: why didn’t I get offered more of these physical explanations as opposed to psychological ones? What makes ‘not eating’ almost by definition a mental disorder for most people? What other behaviour are we inclined to label as a mental disorder rather than staying open for other explanations?

What makes mental disorders ‘mental’? Does the cause need to be mental (for example in the brain), or are just the symptoms mental (for example erratic behaviour)? Nowadays many people understand mental disorders, such as depression and schizophrenia, as chemical imbalances in the brain. However, there can be very many different causes for so called ‘mental illnesses’.

Some ‘mental’ disorders have a strong biological cause. Thyroid problems, for example, can lead to symptoms that can be easily mistaken for mental illness. People with an overactive thyroid may show symptoms of depression and anxiety – even schizophrenia in extreme cases. To treat them with antipsychotic medication is of course ineffective. When Robin William committed suicide, the logical explanation, most people thought, was that it was due to his depressions. But the autopsy revealed that he also suffered from a range of physical diseases: Parkinson and Lewy body dementia.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.